Med J Tabriz Uni Med Sciences Health Services. 2007;29(4): 97-101.
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Comparative Study of Simultaneous Preperitoneal Inguinal Herniorrhaphy and Open Prostatectomy with Isolated Inguinal Herniorrhaphy

*Corresponding Author: Email: davoudnourizadeh@yahoo.com


Background and Objectives: Benign prostatic hyperplasia (B.P.H) and inguinal hernia are both age dependent processes and the incidence of them increases steadily with aging in adult male and many older men have B.P.H and inguinal hernia simultaneously. Open prostatectomy and inguinal herniorrhaphy by two separate incisions consume a lot of time that is a risk factor for old patients. We suggest a technique in which complications and time need for simultaneous treatment of B.P.H and inguinal hernia is low. Materials and Methods: A prospective study carried out in 83 patients with symptoms of B.P.H and inguinal hernia carried out in Amiralmomenin and Emam Hospitals (group 1), during seven years (September 1998-2005). Routine blood tests and ultrasonography of urinary tract demanded for all of patients. By midline incision, preperitoneal space was exposed, hernial sac separated and then hernial defect closed by two or three number zero prolan sutures before prostatectomy. Age, laterality of inguinal hernia, operating time, post operative complications and the rate of recurrence for inguinal hernia in all group recorded. Result of group 1 compared with another 54 patients (group 2, just only isolated hernia). Results: Over a 7 year period, , from 83 patients only 80 patients followed up for 1-2 year (mean 16.2 months) and 95 inguinal hernia were repaired in group one. The mean age of patients was 73.7 years and mean operating time for herniorrhaphy part was 11.2 minutes, sixty five patients have unitateral and 15 have bilateral hernia. Eighty hernia were indirect and 15 were direct. Seventy five primary and 20 were recurrent hernias. Wound hematoma and wound infection were not seen. The recurrence rate for inguinal hernia was 4.2% (4 hernia). However, in patients with inguinal herniorrhaphy as a separate approach (group two), mean age of patients was 46.8 years and mean operating time was 35 minutes. There was only one case of wound hematuma (1.5%) and also chronic inguinal pain (1.5%). Recurrence rate for inguinal hernia was 3% (two cases). Conclusion: Simultaneous preperitoneal herniorrhaphy and open prostatectomy consumes less time in comparison with prostatectomy and inguinal herniorrhaphy as separate operations and it is a reliable and safe alternative for patients with both prostate enlargement and groin hernia. The operation method is simple and effective, especially for older men with bilateral inguinal hernia or recurrent inguinal hernia.
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Submitted: 02 May 2010
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